ArticleNeuroradiology2026
Deep learning-based vessel segmentation in non-contrast black-blood MRI for treated aneurysm follow-up: a comparative study with TOF-MRA and DSA.
Article in Neuroradiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionAutomated segmentation of intracranial vessels in 3D black-blood T1W-MRI is feasible. This study evaluates its utility for detecting recurrent aneurysms and compares automatically labeled MRI (AL-BB-MRI) with time-of-flight MRA (TOF-MRA) and digital subtraction angiography (DSA). MATERIALS (PATIENTS) AND
methodsFor model development, the basal intracranial arteries were manually labeled in 37 3D black-blood T1W-MRI examinations from 31 patients with previously endovascularly treated aneurysms. An independent, consecutive series of 84 patients with 90 aneurysms was assessed by three readers to identify recurrences in AL-BB-MRI and TOF-MRA. DSA served as the reference standard when available.
resultsThe model achieved adequate vessel segmentation (Dice = 0.81). Agreement between AL-BB-MRI and TOF-MRA was in 70/90 (78%) aneurysms. Major recurrence rates were similar: 16/90 (18%) aneurysms on AL-BB-MRI and in 14/90 (16%) aneurysms on TOF-MRA. Discrepancies were most common in anterior communicating aneurysms (seven seen only in AL-BB-MRI) and basilar artery aneurysms (five only in TOF-MRA). Compared to DSA (n = 22), AL-BB-MRI had similar accuracy (73% vs. 77%), sensitivity (62% each), and specificity (79% vs. 86%). AL-BB-MRI and TOF disagreed in nine aneurysms: AL-BB-MRI was false positive in three and false negative in two, while TOF-MRA was false positive in two and false negative in another two aneurysms.
conclusionsAL-BB-MRI showed high agreement with TOF-MRA in recurrence detection of aneurysms in the anterior circulation. Both modalities performed similarly against DSA. AL-BB-MRI was superior after flow-diverter or stent-assisted treatment but less reliable for intrasaccular flow disruption. (Level of Evidence: 5B). The study was registered in the German Clinical Trials Register (DRKS00014644) on 07.05.2018.
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